{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:11:58Z","timestamp":1788433918344,"version":"build-2803163510"},"reference-count":31,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Qom University of Medical Sciences","award":["991307 and ethical code IR.MUQ.REC.1399.264"],"award-info":[{"award-number":["991307 and ethical code IR.MUQ.REC.1399.264"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Toxicol Ind Health"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>One of the major toxic effects of exposure to ammonia is the resulting pulmonary acute and chronic effects. This study investigated the acute pulmonary effects of exposure to ammonia lower than the recommended threshold limit value (TLV). This cross-sectional study was conducted in 2021 in four chemical fertilizer production industries using ammonia as the main raw material. A total of 116 workers who were exposed to ammonia were investigated. The level of exposure to ammonia was measured by NMAM 6016, and the evaluation of pulmonary symptoms and function parameters was done using the American Thoracic Society and European Respiratory Society protocols in four sessions. The paired-sample t-test, repeated measures test, Chi-square, and Fisher\u2019s exact test were run to analyze the collected data. The prevalence rates of pulmonary symptoms, including cough, dyspnea, phlegm, and wheezing, were 24.14, 17.24, 14.66, and 16.38%, respectively, after one exposure shift. It was observed that all pulmonary function parameters were reduced after one exposure shift to ammonia. The results revealed that the parameters of vital capacity, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), the FEV1\/FVC ratio, and peak expiratory flow significantly decreased ( p &lt; 0.05) across four exposure shifts. The findings indicated that exposure to ammonia at concentrations lower than one-fifth of TLV could bring about acute pulmonary effects and reduce pulmonary function parameters, similar to the pattern observed in obstructive pulmonary diseases.<\/jats:p>","DOI":"10.1177\/07482337231185463","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T07:03:44Z","timestamp":1688367824000},"page":"471-479","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Does exposure to ammonia concentrations lower than the threshold limit value cause acute pulmonary effects?"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6976-1276","authenticated-orcid":false,"given":"Ahmad","family":"Soltanzadeh","sequence":"first","affiliation":[{"name":"Department of Occupational Health & Safety Engineering, Faculty of Health, Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyyed Hassan","family":"Adeli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Qom University of Medical Sciences, Qom, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Sadeghi Yarandi","sequence":"additional","affiliation":[{"name":"Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Heidari","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Engineering, School of Public Health, Golestan University of Medical Sciences, Gorgan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3874-3438","authenticated-orcid":false,"given":"Mohsen","family":"Mahdinia","sequence":"additional","affiliation":[{"name":"Department of Occupational Health & Safety Engineering, Faculty of Health, Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"bibr1-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1179\/oeh.2001.7.1.19"},{"key":"bibr2-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1016\/j.jenvman.2018.01.021"},{"key":"bibr3-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201003-0451OC"},{"key":"bibr4-07482337231185463","unstructured":"Ashley K, O\u2019Connor PF (2017) NIOSH manual of analytical methods (NMAM)"},{"key":"bibr6-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.13960"},{"key":"bibr7-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1007\/s11011-016-9938-3"},{"key":"bibr8-07482337231185463","unstructured":"Duijm NJ, Markert F, Paulsen JL (2005) Safety assessment of ammonia as a transport fuel."},{"key":"bibr9-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-2192"},{"key":"bibr5-07482337231185463","first-page":"14","volume":"81","author":"GAotWM Association","year":"2014","journal-title":"The Journal of the American College of Dentists"},{"key":"bibr10-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"bibr11-07482337231185463","doi-asserted-by":"publisher","DOI":"10.4103\/2045-9912.273958"},{"key":"bibr12-07482337231185463","doi-asserted-by":"publisher","DOI":"10.1007\/s11270-007-9353-9"},{"key":"bibr13-07482337231185463","unstructured":"Hygienists ACoGI (2019) 2019 TLVs\u00ae and BEIs\u00ae Based on the Documentation of the Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices. 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